Understanding stuttering

Stuttering affects over 3 million Americans. While it’s often easy to recognize that someone has the condition, there are many myths surrounding what causes stuttering.

This week on “Take Care,” Jane Fraser, president of the Stuttering Foundation of America, helps clear up some of those misconceptions about stuttering. The foundation is the oldest and largest nonprofit organization dedicated to the prevention and treatment of stuttering. Fraser is the daughter of Stuttering Foundation founder Malcolm Fraser, who established the organization in 1947.

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We all know it when we hear it. Fraser says the definition of stuttering is a communications disorder in which the flow of speech is broken. There are basically three kinds of ways that can happen.

With little children, Fraser says, repetition of sounds is the most commonly heard. “Like this” comes out “li-li-li-like this,” according to Fraser.

Or it can be a prolongation of sound. “Suuuuuuch as this,” said Fraser. Or, like, “mmmmmmmommy, I want an ice cream cone,” she said.

The third kind of stuttering is a stoppage of speech, when no sound comes out at all.

Fraser says four factors play a role in the cause of stuttering. The first is genetic predisposition. Fraser says her dad, uncle and some of her first cousins have all stuttered. Among stutterers, 60 percent have somebody else in the family who stutters. Scientists believe that number may be as high as 80 percent.

Fraser says stuttering is a neurophysiological problem. Speaking involves an extraordinary amount of coordination. Fraser says 45,000 neuromuscular events per second occur just to say one word. And as Fraser points out, a little child just learning to speak can have trouble balancing that.

Third, the pace of a child's development can be a factor. Some children at age 2 and 3 have phenomenal language ability, says Fraser. But that may be more than their young motor skills can handle. For example, a child that is super bright and uses long sentences can all of a sudden have a breakdown in speech. Fraser describes that as a case of a mismatch between vocabulary and speaking ability. In that situation, you want to bring things back into sync. Fraser recommends not using such long sentences with that child; don’t encourage him or her to use the big words.

And lastly, family dynamics can play a role. Fraser says that’s usually when a child is laidback and the family has high expectations and puts a lot of pressure on the child. Fraser notes that’s not technically a cause of stuttering. But if you put too much pressure on child just as he or she learning to speak, it can cause some breakdowns and the child can react to those.

The most common age for the onset of stuttering is overwhelmingly age 2-3. Fraser says 80 percent of calls from parents to the foundation over the decades have children that age. Some children will begin stuttering at age 4 or 5. Fraser says later onset is sometimes more worrisome.

If it happens at a later age, experts don’t really know why, says Fraser. But sometimes, she says, later onset can actually be late recognition of the problem. Sometimes children are good at hiding their stuttering, then if they’re put in a stressful situation, the stuttering becomes apparent.

But Fraser says when stuttering does begin late, it’s important to get help right away and discuss anything else that might be going on in the child’s health with your pediatrician.

As far as treating stuttering, Fraser recommends some easy steps. Stop bombarding your child with questions. Remove the pressure to speak. Give your child more time to answer. Fraser says the foundation encourages parents to speak at the age level the child is.

“We don’t need a baby Einstein, particularly if you notice that child is struggling a little bit,” Fraser said.

She also recommends special time, one-on-one, between a parent and the child. Five minutes with that child alone, full attention with no audio-visual distractions, can make a huge difference for that child, she says.

Fraser’s best advice is that it’s important to be open about stuttering, talk about it normally.

“Kids sometimes have trouble talking. Just acknowledge that fact -- sometimes it’s hard to talk – rather than getting terribly worried, which doesn’t help anybody. It doesn’t help parents; it doesn’t help the child. And seek help.”